Bureau of Communicable Disease Control, New York State Department of Health, Albany, USA.
J Public Health Manag Pract. 2011 Jan-Feb;17(1):4-11. doi: 10.1097/PHH.0b013e3181fb0071.
A process evaluation was conducted to evaluate a newly established active influenza surveillance program that utilized 6 sentinel hospitals to collect epidemiologic information for influenza-like illness admissions. Objectives were to determine whether the new system was implemented successfully and met surveillance objectives, including determination of the proportion of patients with 2009 H1N1 influenza, extent of disease severity, and identifying high-risk groups.
Timeliness and data quality were assessed through analysis of electronic case report form completion and timing of specimen collection and submission to public health laboratories for influenza testing. Simplicity and accessibility of the surveillance system were assessed through a survey of hospital-based surveillance staff.
The median number of days from admission to initial reporting was 5 days. The completeness of core variables was more than 98%, 96.2% for complications, and 92.6% for underlying medical conditions. Among influenza-like illness admissions, 77.8% had a specimen submitted for confirmatory testing. Eighty-nine percent of survey respondents found guidance provided by New York State Department of Health to be helpful and case report forms easy to use.
This project was implemented within a context of limited time and resources. Certain aspects of planning, such as securing necessary staffing at some hospitals, could not be carried out prior to implementation. Resource limitations necessitated controls on the numbers of specimens submitted each week. Some reporting lags were noted because of delays in data entry. Reporting timeframes allowed for timely data summarization for internal decision making. Maintaining frequent contact with sentinel sites promoted report completeness, timeliness, and consistency across sites. These results highlight the value of sentinel surveillance methodology and challenges of rapidly deploying a new active surveillance system for an emergent disease.
进行了一项过程评估，以评估一个新建立的主动流感监测计划，该计划利用 6 家哨点医院收集流感样疾病入院的流行病学信息。目的是确定新系统是否成功实施并达到监测目标，包括确定 2009 年 H1N1 流感患者的比例、疾病严重程度的程度以及确定高风险人群。
通过分析电子病例报告表的完成情况以及标本采集和提交公共卫生实验室进行流感检测的时间，评估及时性和数据质量。通过对医院监测人员的调查，评估监测系统的简单性和可及性。
从入院到首次报告的中位数天数为 5 天。核心变量的完整性超过 98%，并发症为 96.2%，基础疾病为 92.6%。在流感样疾病入院患者中，77.8%的患者提交了用于确认检测的标本。89%的调查受访者认为纽约州卫生部提供的指导很有帮助，病例报告表易于使用。
该项目是在有限的时间和资源的背景下实施的。某些规划方面，例如在某些医院获得必要的人员配置，无法在实施之前进行。资源限制需要对每周提交的标本数量进行控制。由于数据录入延迟，出现了一些报告延迟。报告时间表允许及时汇总数据，以便内部决策。与哨点站点保持频繁联系促进了报告的完整性、及时性和站点之间的一致性。这些结果突出了哨点监测方法的价值以及快速部署针对突发疾病的新主动监测系统的挑战。
